Injuries to face, ears, eyes, nose, throat Flashcards
Prorities in facial trauma (5)
- Airway maintence
- in line imobalizatioon (if suspecting spinal)
- oro-phaeynx bleeding control
- LOC management
- Shock prevention/tx
evaluation for facial injuries steps
Observe- Look for ecchymosis, swelling, lacerations, puncture wounds etc
-Check for CSF from ears/nose, racoon eyes, battle sign, blood from ear
First aid for facial injuries (general)
Check scene
Call EMS (if life threatening injury)
Care: ABCs
Secondary: tx non life threatening, control bleeding, pt forward lean so blood goes out
When should u suspect a facial fx
- facia features distorted
- pt ecperiencing any numbness/pain
- hard to open/close jaw
- Teeth no longer normally aligned
- double vision
Signs + symptoms of facial fx
- malocclusion
- elongated face
- epistaxis
- periorbital deformity
- facial ecchymosis
most import item to note on initial facial exam
Dental occlusion
–When teeth don’t line up and the jaw isn’t closing right
What % of dental injuries are sport related
13-39%
(most aged 8-5)
mc upper incisors
management for soft tissue dental injury
- small cuts/hematomas best tx with direct pressure and ice
- large internal cuts in mouth bleed profusely but heal quick
- larger extra oral cuts must be cleaned and closed with stern strips
Crown/root fx management
If pulp (nerve) is involved, need to cover fractured part ASAP -Need urgent dental tx to prevent infection and prevent the need for root canal
Tooth displacement tx
- Put affected teeth back into as normal a pos as possible
- hold them in place
- immediate dental consult
Tooth avulsion (tooth popped out) tx
Replace tooth in socket ASAP
rinse debris off tooth
handle tooth by crown
if can’t be reimplanted store tooth in appropriate medium
Storage mediums for teeth
dry <30m Tap water 30-60mins vestibule of mouth 90-120 physiologic saline 90-120 cold milk 3hr
internal bleeding control of cheek management
place several folded dressings inside mouth against cheek, apply pressure
External bleeding control
-place several dressings on the outside of the cheek and apply pressure
Emmbed objects in cheek managemetn
may have to be removed to control bleeding and protect airway
-ONLY exertion to general rule of not removing embedded objects
eye exam serious symptims
Tensly swolen, ecchymosis, eyelids don’t open together
Eye injury exam
Inspect: conjunctiva, sclera, pupils, iri, cornea palpate orbital rim examine for exophthalmos, enophthalmos Movement (H patten) Visual acuity (sneellin)
what does PERRLA stand for in eye exam
Pupils equal
round
reactive to Light
Accomidation`
Extruded eye tx
- do not try to put back in
- tx associated injuries and control bleeding
- apply sterile saline wetted dressing around eye
- apply a cut or ring tent manage over eye
- patch opposite eye (due to congugated mints)
tx of burn to eye
flush w sterile saline/water
-Flush the eye from the inner corner to outer (prevent from getting in other eye)
urgent eye referral via 911
Ruptured globe, extruded eye, embedded sharp object
When to refer to opthalmologist asap rocky
Visual field loss
visual acuity loss
photophobia
diplopia
tx of auricular hematomas
- ice local
- sterile needle aspiration
- after aspiration, contoured compression dressing is applied
- repeated aspiration as needed
Tympanic membrane rupture s/s
- Pain and varying severity
- muffled hearing
- possibly bleeding
- tinitus
- vertigo
Epistaxis (nosebleed) tx
- leaning forward pos
- tell to compress entire fleshy part below bridge and maintain compression until bleeding stops
- if doesn’t stop in 20 transport to hospital
if blood from nose is kinda yellow
CSF, suspect skull fx
tx for nose fx
control bleeding
- pt pos seated and leaning forward
- if reduction is required, ideally it is carried out immediately
Classic symptoms of laryngeal trauma
- hoarsness
- dyspnea
- dysphagia
- pai/tendernesss of ant neck
tx for throat lacerations
- Apply direct pressure to the affected side
- apply a sterile first layer then continue to add bandages
- control bleeding and then protect + maintain airways
- once bleeding controlled apply supplemental oxygen
